Protect Your Health

Special Enrollment

If you’ve had certain changes in your life like turning 26, moving, getting married, having a baby or losing health coverage, you may still be eligible for a new health plan. You may have less than 60 days after your qualifying life event to make a change. Contact us now about your deadline.

Turning 26 years old

Having a baby

Getting married or divorced

Moving to a new state

Changes to your job status or income

Choose a Plan Tool

There are four different levels of exchanges health plans: Bronze, Silver and Gold plans are available in all our markets. Platinum plans have limited availability. All of our Health Insurance plans help keep you healthy with $0 preventive care services.

Everything you need to know

Finding a new health plan doesn’t need to be hard. Our checklists can help you choose what’s right for you. If you’ve already chosen health insurance in 2014, you can keep your coverage or change your plan for 2015. If you’re shopping for insurance for the first time, get started here.

Find out if you qualify for financial help

You may want to see if you qualify for financial help (a subsidy), which can lower your monthly health insurance premium. If you qualify for a subsidy, you can subtract some of that tax credit from the amount you pay each month. Visit the links below to see if you qualify.

Add the costs

Think about your 2015 health costs and how much care you may need in 2015. Is it more important for you to have a lower monthly premium and pay more “out-of-pocket” in copays and coinsurance when you get care? Or is it more important for you to pay a little more each month because you may need more care or want to have access to a bigger network of doctors?

Avoid the tax penalty

The Affordable Care Act is the federal law that requires almost every U.S. citizen to have health insurance or else pay a tax penalty. This tax penalty is administered by the Internal Revenue Service (IRS) through the tax return system and could be subtracted from your potential refund.

Remember, your health is important.

The Bronze Plan

The bronze plan offers the lowest monthly premium, but will result in you paying higher out-of-pocket costs, which means you’ll still pay a higher copay each time you visit the doctor for non-preventive care. You receive your preventive care at no cost. You would choose a plan like this if you don’t plan on needing much health care.

The Silver Plan

The silver plan offers mid-range monthly premiums, and will result in you paying mid-range out-of-pocket costs, which means you’ll still pay a copay each time you visit the doctor for non-preventive care. You receive your preventive care at no cost. You would choose a plan like this if you want health coverage for basic care needs or if you plan to see a doctor more frequently than your annual preventive appointment.

The Gold Plan

The gold plan offers a higher monthly premium, but will result in you paying lower out-of-pocket costs, which means you’ll pay a lower copay when you visit the doctor for non-preventive care. You receive your preventive care at no cost. You would choose a plan like this if you need more health care or see your doctor regularly.

The Platinum Plan

We only offer platinum plans in California and New York. The platinum plan has the highest monthly premiums, but will result in you paying the lowest out-of-pocket costs, which means you’ll pay the lowest copay when you visit the doctor for non-preventive care. You still receive your preventive care at no cost.

Affordable Care Act

This is the federal law that requires almost every U.S. citizen to have health insurance or else pay a penalty. The law also creates the structure for a set of government-regulated and standardized health care plans in the United States to be made available on exchanges from which individuals can purchase health insurance for themselves.

Coinsurance

If you have a coinsurance, you’ll owe a percentage towards a covered health care service after you’ve met your deductible. Your health care provider picks up the rest of the bill. So if your coinsurance is 20%, your insurance company pays 80% of the cost of in-network care and you pay the remainder.

Copays

A copayment is a fixed fee that you pay out-of-pocket for each visit to a health care provider. For example, if your co-payment is $30, then you pay $30 when you see your doctor — usually at the time you receive treatment. The amount of your co-payment sometimes varies by the type of health care service you receive.

Deductible

Sometimes, you’ll need to pay a certain amount towards your health care first, before for your provider will begin to pay. The amount you pay is called a deductible. So if yours is $1000, your plan won’t pay anything until you’ve met your $1000 deductible for covered health care services subject to the deductible.

Exchanges

The Exchanges are state or federal run online marketplaces offering people a place to enroll for health insurance coverage. The exchanges may offer up to four different standardized levels of coverage to help people compare which option might be best.

Preventive Services

These services cover children and adults so everyone can benefit. They include yearly checkups, immunizations, flu shots, cholesterol tests, mammograms and more.

Understanding the plans

If you think you won’t go to the doctor often, consider a plan with a lower monthly premium and higher copay (out-of-pocket costs) when you get health care. If you think you or your family will go to the doctor more often, consider a plan with a higher monthly premium and lower copay (out-of-pocket costs) when you get health care.

Let’s say you choose a gold plan as an example. After receiving your zero cost preventive care, the plan would pay an average of 80% of covered health care costs while you would pay 20% through some combination of deductibles, co-payments or coinsurance. Similarly, a silver plan pay would pay an average of 70% of covered health care costs while you would pay 30% through some combination of deductibles, co-payments or coinsurance. Bronze plans only cover an average of 60% of covered health care costs, increasing your co-payment to 40%.

Health Care

The diagnosis, treatment, and prevention of disease, illness, or injury. Health care is delivered by practitioners in medicine, optometry, dentistry, nursing, pharmacy, and other care providers.

Health Insurance

Health insurance is a contract between you and the insurance company that says that the insurance company will pay a portion of your medical expenses if you get sick or hurt and have to visit a doctor’s office or hospital. The amount of your bill that the insurance company will pay, and under what circumstances they'll pay it, is known as coverage and can vary greatly from policy to policy.

Out-of-Pocket Costs

An out-of-pocket cost would be the amount of money you yourself pay towards your health insurance bills. This may be because of your health insurance plan’s policy, or because you are being billed for a procedure or physician outside of your plan.

Out-of-Pocket Limit

Your out-of-pocket limit is the most you will pay for in-network deductibles, co-insurance and co-payments during a policy period (usually a year) before your health insurance or plan begins to pay 100% of the allowed amount. This limit does not includes your premium, balance-billed charges, out-of-network charges or health care your insurance or plan doesn’t cover.

Tax Penalty

If an individual does not buy health insurance coverage and does not qualify for exemptions, the new Affordable Care Act creates a structure for charging a penalty tax. This penalty tax is administered by the Internal Revenue Service (IRS) through the tax return system.

Pre-existing condition

Pre-existing conditions are health problems you had before getting coverage. This could be something like diabetes, cancer or asthma and you can’t be denied coverage, or charged different rates, regardless of your medical history, gender or health status.

Premium

A premium is the amount that must be paid for your health insurance or plan. You usually pay it monthly, quarterly or yearly.

Primary Care Physician (PCP)

A physician (M.D. – Medical Doctor or D.O. – Doctor of Osteopathic Medicine) who directly provides or coordinates a range of health care services for a patient. To put it simply, a Primary Care Physician is the doctor you see on a fairly regular basis.

Qualifying Life Event

From Feb. 15, 2015, to Oct. 15, 2015, you can only get health insurance coverage through the online marketplace within 60 days of having a qualifying life event.

Examples of qualifying life events include turning 26, moving to a new state, getting married or divorced, having or adopting a baby, or certain changes to your job status or income.

In some cases, misconduct by a non-Marketplace enrollment assister (like a navigator, certified application counselor, or agent or broker) which caused you to not get enrolled or be enrolled in the wrong health plan may also qualify you for a special enrollment period.

After most events, you must lock in your new health benefits within 60 days. If you think you qualify for a special enrollment period, go ahead and start an application. As you finish your application, you’ll see a statement that you can enroll only if you have a special enrollment period. Continue the process to explain your situation and enroll in a plan. You can also contact us now to plan ahead or get help enrolling.

Subsidy

A subsidy is a premium tax credit used to offset or lower the cost of health insurance coverage. U.S. citizens in families with incomes between 100% and 400% of the national poverty level who purchase coverage through a health insurance exchange may be eligible for this tax credit to reduce the costs of coverage, but the amount of the credit received can change based on where you live and what products are available in your marketplace or exchange.

Serving Indiana, Kentucky, Missouri (excluding 30 counties in the Kansas City area), Ohio, Wisconsin, Colorado, Nevada, Connecticut, Maine, New Hampshire and Virginia (excluding the city of Fairfax, the town of Vienna and the area east of State Route 123). Anthem Blue Cross and Blue Shield is the trade name of: In Colorado and Nevada: Rocky Mountain Hospital and Medical Service, Inc. In Connecticut: Anthem Health Plans, Inc. In Georgia: Blue Cross and Blue Shield of Georgia, Inc. and Blue Cross Blue Shield Healthcare Plan of Georgia, Inc. In Indiana: Anthem Insurance Companies, Inc. In Kentucky: Anthem Health Plans of Kentucky, Inc. In Maine: Anthem Health Plans of Maine, Inc. In Missouri (excluding 30 counties in the Kansas City area): RightCHOICE® Managed Care, Inc. (RIT), Healthy Alliance® Life Insurance Company (HALIC), and HMO Missouri, Inc. RIT and certain affiliates administer non-HMO benefits underwritten by HALIC and HMO benefits underwritten by HMO Missouri, Inc. RIT and certain affiliates only provide administrative services for self-funded plans and do not underwrite benefits. In New Hampshire: Anthem Health Plans of New Hampshire, Inc. In Ohio: Community Insurance Company. Anthem Health Plans of Virginia, Inc. trades as Anthem Blue Cross and Blue Shield in Virginia, and its service area is all of Virginia except for the City of Fairfax, the Town of Vienna, and the area east of State Route 123. and its affiliated HMOs, HealthKeepers, Inc., Peninsula Health Care, Inc. and Priority Health Care, Inc. In Wisconsin: Blue Cross Blue Shield of Wisconsin ("BCBSWi") which underwrites or administers the PPO and indemnity policies; Compcare Health Services Insurance Compcare Health Services Insurance Corporation ("Compcare") underwrites or administers the HMO policies; and Compcare and BCBSWi collectively underwrite or administer the POS policies. Independent licensees of the Blue Cross Blue Shield Association.